Male’s Health in the Objective of Stressology – Beyond the Usual. Армен Мурадян

effects are a vector complex systemic response to traumatic events. The generalization of multiple research results of different aspects of traumatic stress described as the structure of self (Laufer); a cognitive model of the world of the individual (Yanov-Boulemane); the affective sphere (Kristal); the neurological mechanisms controlling the processes of learning (Kolb); the memory system (Pittman); emotional learning (LeDoux Romanski) are obvious proofs that the post-stress process involves the entire complex system of man. The leading element is the human ability to attach meaning to any, sometimes even indifferent stimulus (a phone call, the night phone call, a special knock on the door, sleep, crow’s cry). Stress becomes “traumatic” when the meaningful significance of what has taken place results in disorders in the psychosomatic sphere, which is similar to the physical injury – hence is the name (mental injury, mental crash-syndrome). However, in contrast to a physical injury a mental wound can be invisible; it does not impress bystanders with a bloody mash of muscles, vessels and nerves. A spiritual crash-syndrome is a “silent volcano” that can burst at any time, at any place, by any kind of suffering.

      In the concept of traumatic grief of Linderman (1944) and “syndrome of stress reaction” of Horowitz (1986) a factor of “time” after trauma during which a person experiences mental discomfort, anxiety, aggression and grief, occupies a special place. As a result the term “chronic stress” appeared alongside with the term “acute stress”. Chronic stress assumes remote aftermaths occurring after disappearance of stressor effect.

      Opponents of the concept of a unified mechanism of stress and post-stress disorder, being aware of the affinity of these concepts, suggest using the term “stress” for correctness, to denote the immediate response to stressor and the term “post-traumatic mental disorders” for delayed reactions to the traumatic stress. We think that such “correctness” would adversely affect the understanding of an integral process.As a result, comparison would be done to quite differing conditions, for stress in its classical meaning is a normal response of the body to a stressor, while PTSD is a disease. They are however connected via the integral mechanism of stressogenesis, which changed its function; the function of protection became the function of destruction. It is here that an “impassable” barrier to see the unity of stress and post-stress disorders appears, the emergence of which is connected with the fact that stressogenesis as a normal adaptation reaction becomes a pathogenesis of post-stress disorders. Flashbacks, imagination stipulate transition from acute stress to chronic depriving it from the main peculiarity – discrecity, moving to the category of permanent processes entailing conversion from the norm to pathology.

      In her early works (2002–2011) A. Tadevosyan described traumatic stress under the name of APES – Antropogenic Psycho-Emotional Stress thus underlying its specificity already in the name. APES is specific for man and contains both emotional and cognitive components, the proportion of them varying depending on the memory peculiarities of a particular person, his personality, peculiarities of perception, content and duration of the state of grief. Resulting from the interaction between the stressor and the mental vulnerability of man, a state of deadaptation has a number of specific features relevant to man only, which mark its distinction from the emotional stress in general (A. Tadevosyan, 2002, 2003, 2011). An individual, having suffered a mentally traumatic situation himself or as its witness, experiences the emotional stress as an acute state. Actually, this first phase of stressor response as the first step of man’s response to a traumatic event can be easily modeled on animals. When the first emotional outbreak (shock) of traumatic experience somewhat calms down man begins to think over what had happened; memory, comprehension are turned on, the past, present (the cognitive component of the psyche) are assessed often from the standpoint of loss for the person himself. The trauma acquires the category of meaning for a particular man. “The meaningfulness” of injury, its sense results from processing the life entire past, present aimed at the search for “anchors” for the future. Sometimes it takes quite a long time to interpret what happened in detail; during this period “molecules” of emotions of various qualities, various intensities and duration are released. The variety of emotional experience of this period depends on what man remembers about stress, what the content of his traumatic memory is. The emotional palette when alone (stress outprice) can be very dynamic and manifold: from anger, wrath, to the sense of guilt, despondency. The flow of these conditions may be undulating: the emotional tension going up and down. Thus usually the emotional discharge proceeds gradually reducing the destructive activity of the injury – “time heals”. However, there are cases when deliberation of what happened may be accompanied by a growing emotional experience intensified by assuming a personal role in the loss, the rejection of a random set of circumstances, self-blame. This can result in self-generation of an affect with suicide or alcoholization, psychopathology or somatization of the injury. Thus, processing of the event may be accompanied by the second emotional wave, which in a number of cases is much stronger than when it really happened. This stage includes a new phenomenon of the evolution – consciousness and imagination.

      The first mention about the cognitive aspect of mental stress is found in R. Lazarus work. He notes that only an interpretation of the fact or a situation makes the stimulus stressogenic. The evaluation attributed by the individual to a specific factor is the main intermediate variable between the stressor and the response. Defining stress as a situation whereby the requirements to a person are either a trial or something that exceeds his capabilities for adaptation, Lazarus concludes that even if a stimulus affects the individual through some sensorial or metabolic process, this process being stressogenic, the stressor response may fail to appear. A stimulus becomes a traumatic stressor only by virtue of the meaning ascribed to it by man. Therefore, an excessive stress can be initiated by the individual himself, by the one who ascribes sometimes the stressing characteristics even to the neutral stimulus.

      This feature was already known to philosophers of the ancient world, who wrote: “People are frustrated not by an event, but rather by how they see it” (Epictetus). And Andre Gide wrote: “How wonderful life would be if we were content with some real disasters, not bowing to the ghosts and chimeras of our mind…”.

      Usually three periods are distinguished after an injury:

      The acute period can be considered up to 3 months.

      Subacute period lasts up to 3–6 years.

      Delayed or remote consequences can be extended for years, sometimes for the whole life.

      Example from a husband’s story:

      “I cannot understand why she did it now. We lost a child 3 years ago, she handled herself well. We have born a girl again. Life began to improve. And suddenly – she commits suicide, leaving a note: “I’m sorry. All this time, I tried to forget … every time embracing our second daughter, I see the face of my daughter, she looks reproachfully at me. I can no longer”… (from the suicider’s note).

      Mental trauma is an act of the impact of mentally traumatizing event limited in space and time “there and then”. The traumatic event, having become the content of consciousness, in the course of time can be repeatedly manifested as unprompted flashbacks or initiated by the individual himself anywhere, anytime and in any situation. Its strength and meaningfulness can be amplified by the imagination, which manipulates the traumatic experience, moving it in time, expanding by connecting other people and events. Thus the state of traumatization develops, the core of which is the so-called in psychology and psychoanalysis “trauma body”. At the level of consciousness the “trauma body” (psychoanalytical term) or a traumatic constellation (neuro-physiological term) has a basic quality – the quality of attracting everything that can be tied up into a “single unity” and comprise a traumatic reality.

      The latter does not already have clear space-time boundaries. Man “starts to live” not in the objective reality, but rather in the subjective post-traumatic one. Each time when activating that reality, man lives all through again with the whole complexity of the sensory perception of the traumatic injury, the somatovegetative symptomocomplex, supplemented with the affectivity of the moment and the behavior of the traumatized man during the traumatic injury. As a result, the act of “mental trauma” goes over into a “condition of mental traumatization” converting